There are three kinds of medicines for osteoporosis. Most come as pills. A few are given by a shot under the skin or directly into the vein using an IV. One is a nasal spray.Some are taken once a day. Others are taken once a week, once a month, or even less often.

Bisphosphonates

Bisphosphonate (biss-FOSS-fuh-nate) drugs include alendronate (Fosamax®), ibandronate (Boniva®), risedronate (Actonel®), and zoledronic acid (Reclast®). They stick to the surfaces of the bones and slow the breakdown of old bone.

SERMs

Selective estrogen receptor modulators (SERMs), like raloxifene (Evista®), slow the breakdown of old bone. They are not hormones but work on bone like the hormone estrogen.

Hormones

Estrogen (Premarin®) and estrogen plus progestin (Prempro®, Premphase®) pills add to the body’s natural hormones. They slow the breakdown of old bone.

Teriparatide (Forteo®) helps the body make new bone faster than old bone is broken down.

The U.S. Surgeon General says that calcium, vitamin D, and exercise are important for healthy bones. The Surgeon General also warns that smoking and drinking too much alcohol raises the risk of broken bones.

Calcium and vitamin D

Many people do not get enough calcium and vitamin D. Calcium is the building block for bones. Vitamin D helps your bones use calcium. They work together to build bones.

Calcium

Women need more calcium after menopause. Each day you should get at least:

* 1,200 mg of calcium.

Calcium pills can help you meet this goal. Smaller doses of 500 mg or less taken with meals are best.

Vitamin D

Vitamin D needs vary by age. Each day you should get at least:

* 400 IU of vitamin D if you are 51 to 70.

* 600 IU of vitamin D if you are 71 and over.

Many calcium pills and multi-vitamins contain vitamin D. Check the label to be sure.

Exercise

Exercise is good for bone health, muscle strength, and balance. Exercise can help lower the chance of falling. For many people with osteoporosis, falling is what leads to a broken bone.

Vitamin D needs vary by age. Each day you should get at least:

* 400 IU of vitamin D if you are 51 to 70.

* 600 IU of vitamin D if you are 71 and over.

Many calcium pills and multi-vitamins contain vitamin D. Check the label to be sure.

Exercise

Exercise is good for bone health, muscle strength, and balance. Exercise can help lower the chance of falling. For many people with osteoporosis, falling is what leads to a broken bone.

All the medicines in this guide can cause side effects. The chance of serious side effects with osteoporosis medicines can depend on a person’s other health problems. Talk with your doctor or nurse about the risks for you.

Esophagus and stomach problems

The esophagus (eh-SAW-fuh-gus) is the tube that connects your mouth and stomach. Problems with the esophagus and stomach can happen with any of the bisphosphonate pills. Problems include heartburn, nausea, and trouble swallowing. More serious problems include ulcers or bleeding.

Pain

Bisphosphonate medicines can cause pain in your muscles, bones, or joints. If you have pain after starting a bisphosphonate, tell your doctor or nurse. This pain may be a reaction to your medicine. It can start right away or happen after you’ve been on the medicine for a long time.

Breakdown of the jaw bone

You may have heard that bisphosphonates can cause a breakdown of the jaw bone. This rare problem is called osteonecrosis (OSS-tee-oh-neh-KRO-sis). It’s happened mostly with people who have cancer and were taking bisphosphonates. It’s happened with only a few people taking bisphosphonates for osteoporosis..

What is osteoporosis?

Osteoporosis means that bones become less dense (or less solid). When bone density is low, bones become weak and easier to break. Bone density that is low enough for bones to break easily is called osteoporosis.

Who gets osteoporosis?

Half of all women 50 and older will have a broken bone from osteoporosis at some time during their life.

Osteoporosis is more likely for:

*Women after menopause, mostly because the body has less estrogen.

* Smaller and thinner women.

* White or Asian women.

* Women who have family members who had osteoporosis and broke a bone.

* Women who smoke tobacco or drink too much alcohol.

* Women who take certain medicines like thyroid medicine or steroids.

Both men and women can have osteoporosis, but most of the research is about women.

Osteoporosis can cause any bone to break. The most likely bones to break are the spine, hip, or wrist. Bones can break from a fall or just a hard bump.

Spine

Cracks in the bones of the spine can cause these bones to crunch together (compression fracture). This can cause backaches and pain. In fact, loss of an inch or more of height may be the first sign of osteoporosis.

Hip

A broken hip almost always needs to be repaired with surgery. Recovery from the operation can take a long time. A broken hip can raise the risk of serious problems, even death.

Wrist

A broken wrist makes it hard to use the arm and hand. It can also require surgery.